Provider Demographics
NPI:1750769782
Name:MENDEZ, DIANA
Entity type:Individual
Prefix:MS
First Name:DIANA
Middle Name:
Last Name:MENDEZ
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 SANFORD AVE
Mailing Address - Street 2:
Mailing Address - City:DUNELLEN
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-1042
Mailing Address - Country:US
Mailing Address - Phone:732-474-7378
Mailing Address - Fax:732-582-2722
Practice Address - Street 1:314 SANFORD AVE
Practice Address - Street 2:
Practice Address - City:DUNELLEN
Practice Address - State:NJ
Practice Address - Zip Code:08812-1042
Practice Address - Country:US
Practice Address - Phone:732-474-7378
Practice Address - Fax:732-582-2722
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-11
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC056319001041S0200X, 1041C0700X, 1041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool